Seminar CL5 – Medication safety in vulnerable patient groups

Children and elderly patients are at a high risk for problems concerning pharmacotherapy. On the one hand physiologic alterations might influence pharmacokinetic and pharmacodynamic properties of several drugs and on the other hand problems with the application of drugs are more likely to occur in those patient groups.

 

Elderly patients above the age of 65 are the most considerable target group for pharmacotherapy, but exactly these patients are often excluded from clinical trials because of their age and/or comorbidities. Therefore only limited evidence based information about pharmacotherapy is available. Some efforts have been undertaken to provide lists of potentially inappropriate medications (PIM) that are associated with increased risk for adverse effects and should be avoided in the elderly. Furthermore, many elderly patients have problems with the handling of drugs, e.g. application of inhalers, opening of blisters or drop counting.

 

There is only limited data from clinical trials for the majority of drugs that are used to treat diseases in childhood. Hence, only small proportions of drugs are formally approved for this patient group which leads to a higher risk for medication errors and adverse effects. Moreover, many drugs are not available in a galenic formulation that is suitable for children.

 

 

• To describe physiologic alterations in special patient groups (elderly, children);

• To review classification systems for potentially inappropriate medication (PIM) in elderly patients;

• To report on problems in drug administration in children and the elderly.

 

 

After the presentation the participant should be able:

 

• to outline parameters, that influence pharmacokinetics and pharmacodynamics in children and elderly patients;

• to value different classification systems for PIM;

• to describe problems with the application of drugs in children and elderly patients.